Hippocampal sclerosis: a common pathological feature of dementia in very old humans
Hippocampal sclerosis: a common pathological feature of dementia in very old humans
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海马硬化：老年痴呆症的常见病理特征
DOI：
10.1007/bf00296500
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发表时间：
2004
影响因子：
12.7
通讯作者：
K. Jellinger
中科院分区：
文献类型：
--
作者：
K. Jellinger
迪克森等人。 [3]，在一项针对 81 名 80 岁或以上受试者的前瞻性研究的神经病理学研究中，观察到 16% 的受试者出现海马硬化症 (HpScl)，26% 的痴呆症受试者出现海马硬化症 (HpScl)。除一名 HpScl 患者外，所有患者均患有痴呆症；虽然大多数病例被认为是“病理性衰老”，但只有 3 例患有明显的阿尔茨海默病 (AD) 和另一例患有弥漫性路易体病 (DLBD)。 8例无AD的病例中，有4例未检测到其他导致痴呆的原因，而另外4例则显示多发性脑血管病变。这些发现表明，HpScl 是痴呆症患者的常见死后发现，但认知正常的老年受试者则不然；它可能会增加患痴呆症的风险，特别是对于患有心血管疾病或有心肌梗塞病史的患者。这些数据至少可以部分地得到来自维也纳痴呆症前瞻性纵向研究[1]的 67 名老年受试者（15 名男性，52 名女性，年龄 54 至 97 岁，平均 79.5 岁）的个人连续尸检结果的部分证实，其中分级精神状态（迷你精神状态 MMS [5]）在死亡前 4-6 个月内进行。使用改良的 Bielschowsky 和 Reusche's [9] 银染剂对多个石蜡包埋切片进行神经病理学研究，并在选定的病例中使用 tau 和泛素免疫组织化学来评估神经炎性 AD 病变和皮质路易体 (LB)。神经病理学评估考虑了目前使用的 AD 诊断标准 [6-8] 和神经炎性 AD 病理学的形态学分期 [2]。在 67 例 MMS 范围为 30 至 0（中位数 9.77 + 10.4 SD）的研究病例中，包括 9 名没有或仅有轻微认知变化的受试者（MMS 25-30）[4]，有 5 例（7.4%），2 名男性和 3 名女性，年龄 67-90（平均 78）岁，存在严重的神经元丢失、海马海绵状变化和神经胶质增生，特别是 CA 1 扇区和 下托，对应于 HpScl [3]。两名患有中度至重度痴呆症的受试者（分别为 MMS 18 和 4），符合 NIA 和 C E R A D AD 标准 [6, 7]； 1显示神经炎性AD分期VI，
Dickson et al. [3], in a neuropathological study of 81 prospectively studied subjects aged 80 years or older, observed hippocampal sclerosis (HpScl) in 16 % of the total and in 26 % of demented individuals. All except one patient with HpScl had been demented; while most cases were considered as "pathological aging", only 3 had overt Alzheimer disease (AD) and another one Diffuse Lewy Body disease (DLBD). In 4 of the 8 cases without AD, no other causes of dementia were detected, while the other 4 showed multiple cerebrovascular lesions. These findings indicate that HpScl is a common postmortem finding in demented, but not cognitively normal elderly subjects; it may contribute to increased risk of dementia particularly in patients with cardiovascular disease or a history of myocardial infarction. These data can, at least in part, be confirmed by findings from a personal consecutive autopsy series of 67 elderly subjects (15 males, 52 females aged 54 to 97 years, mean 79.5 years) from the Vienna Prospective Longitudinal Study of Dementia [1] with graded psychostatus (Mini-Mental status MMS [5]), performed not longer than 4-6 months prior to death. Neuropathology study was performed on multiple paraffinembedded sections using modified Bielschowsky and Reusche's [9] silver stains and, in selected cases, immunohistochemistry for tau and ubiquitin to assess neuritic AD lesions and cortical Lewy bodies (LBs). Neuropathological evaluation considered the currently used diagnostic criteria for AD [6-8] and the morphological staging of neuritic AD pathology [2]. Among the 67 studied cases with MMS ranging from 30 to 0 (median 9.77 + 10.4 SD) including 9 subjects with no or only minimal cognitive changes (MMS 25-30) [4], there were 5 cases (7.4 %), 2 males and 3 females aged 67-90 (mean 78) years, with severe neuronal loss, spongy changes and gliosis in the hippocampus, particularly CA 1 sector and subiculum, corresponding to HpScl [3]. Two subjects with moderate to severe dementia (MMS 18 and 4, respectively), met the NIA and C E R A D criteria for AD [6, 7]; 1 showed neuritic AD staging VI, the
影响因子：
4.6
作者：
Mirra,SS;Hart,MN;Terry,RD
通讯作者：
Terry,RD